Provider Demographics
NPI:1154627016
Name:MCDONALD, CELINA CHRISTINA (LPC-S)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:CHRISTINA
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13625 POND SPRINGS RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78729-4427
Mailing Address - Country:US
Mailing Address - Phone:512-576-4150
Mailing Address - Fax:512-727-7197
Practice Address - Street 1:13625 POND SPRINGS RD
Practice Address - Street 2:SUITE 105
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729
Practice Address - Country:US
Practice Address - Phone:512-576-4150
Practice Address - Fax:512-727-7197
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
TX62447101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218399801Medicaid